Healthcare Provider Details

I. General information

NPI: 1578748745
Provider Name (Legal Business Name): CHARLENE BERNICE ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36000 DARNALL LOOP CARL R DARNELL MEDICAL CENTER
FORT HOOD TX
76544
US

IV. Provider business mailing address

36000 DARNALL LOOP CARL R DARNELL MEDICAL CENTER
FORT HOOD TX
76544
US

V. Phone/Fax

Practice location:
  • Phone: 254-288-8052
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number1-101538
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: